Home Drug Guide Empagliflozin

Drug Guide

Generic Name

Empagliflozin

Brand Names Jardiance

Classification

Therapeutic: Antidiabetic agent

Pharmacological: SGLT2 inhibitor

FDA Approved Indications

  • Type 2 diabetes mellitus to improve glycemic control
  • Reduction of cardiovascular death in adults with established cardiovascular disease and type 2 diabetes

Mechanism of Action

Empagliflozin inhibits the sodium-glucose co-transporter 2 (SGLT2) in the proximal renal tubules, reducing glucose reabsorption and increasing urinary glucose excretion, thereby lowering blood glucose levels.

Dosage and Administration

Adult: Start at 10 mg once daily, with or without food. May increase to 25 mg based on response and tolerability.

Pediatric: Not approved for use in children.

Geriatric: Renal function should be assessed; initial dose may be 10 mg daily.

Renal Impairment: Use caution; dose adjustment may be necessary based on renal function.

Hepatic Impairment: No specific dosage adjustment necessary.

Pharmacokinetics

Absorption: Rapid absorption with peak plasma concentrations in approximately 1.5 hours.

Distribution: Not significantly bound to plasma proteins.

Metabolism: Minimal metabolism; primarily excreted unchanged.

Excretion: Primarily via urine, both as unchanged drug and metabolites.

Half Life: Approximately 12.4 hours.

Contraindications

  • Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
  • End-stage renal disease
  • Patients on dialysis

Precautions

  • Monitor renal function periodically, especially in volume-depleted or hypotensive patients. Use with caution in hepatic impairment.

Adverse Reactions - Common

  • Genitourinary infections (e.g., yeast infections, urinary tract infections) (Common)
  • Hypotension (Common)
  • Increased urination (Common)

Adverse Reactions - Serious

  • Ketoacidosis (including euglycemic ketoacidosis) (Serious rare)
  • Acute kidney injury (Rare)

Drug-Drug Interactions

  • Diuretics, insulin, insulin secretagogues (risk of hypotension, hypoglycemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose, renal function, blood pressure, signs of genitourinary infections.

Diagnoses:

  • Risk for infection
  • Risk for hypotension
  • Imbalanced nutrition related to hyperglycemia.

Implementation: Administer once daily, monitor labs, educate patient on signs of infection and dehydration.

Evaluation: Assess glycemic control, renal function, and patient adherence.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Maintain hydration.
  • Report symptoms of urinary infections, genital infections, or signs of ketoacidosis.
  • Monitor blood glucose regularly.

Special Considerations

Black Box Warnings:

  • Risk of ketoacidosis, which can be life-threatening. Patients should be aware of symptoms (nausea, vomiting, abdominal pain, confusion).

Genetic Factors: Not specifically determined.

Lab Test Interference: May cause false reduction in blood glucose measurements by some methods.

Overdose Management

Signs/Symptoms: Dehydration, hypotension, hypoglycemia in combination with other agents.

Treatment: Discontinue empagliflozin, provide supportive care, manage dehydration and hypotension as needed, monitor renal function.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.